Medicine 3.0: Why Metabolic Health Starts Long Before a Diagnosis
Ask Dr. Herman Weiss what "metabolic" really means and he answers with a story, not a definition. In Episode 2 of the Body Clock Podcast, the OB-GYN, who has more than 25 years in practice, and host Daniel Kaufman continue their conversation about polyendocrine metabolic ovarian syndrome (PMOS), the condition long called polycystic ovary syndrome or PCOS. This time they move from the new name to what it points at: metabolism.
The Titanic had its warnings
Dr. Weiss's parable goes like this. The Titanic received warning after warning about ice. The binoculars that might have helped the lookout were locked away. The water was calm, so the ship kept its speed. By the time anyone saw the iceberg, there was nothing left to do.
That, he argues, is too often how medicine meets high blood pressure, high cholesterol and even infertility: at the point of collision, not at the warnings. Once someone is far down the road to a diagnosis, he says, the way back is much harder. The most useful work happens upstream, while the warnings are still just warnings.
Medicine 1.0, 2.0 and 3.0
To explain what should change, Dr. Weiss walks through a framework popularized by physician Peter Attia in his 2023 book Outlive. Medicine 1.0 was pre-scientific, but it paid close attention to food and movement. Medicine 2.0 brought diagnostics, antibiotics and a drug for each diagnosis, and Dr. Weiss is quick to say he isn't discarding it. Medicine 3.0 keeps all of that science and acts years earlier. Why wait for high blood pressure, he asks, when the chance to act came a decade before?
In his telling, 3.0 also rediscovers something 1.0 knew: food is medicine, and so is movement. Daniel liked the framing so much that he named the episode after it on air.
Sunlight and steps can improve sleep, better sleep can lower stress, and lower cortisol may help your glucose. His practical version is deliberately unglamorous: more steps, and some time outside in daylight. In this episode of Body Clock, learn about the warning signs, why patients are not having that conversation with the physicians, what is the link between stress, blood sugar, and what is being called by doctors “Diabetes type 3”.
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